Cleft Lip & Palate

Cleft Lip and Palate Treatment

Dr. Austin Birch specializes in Cleft Lip & Palate treatment for infants. Part of his pediatric dental residency training included learning the Naso-Alveolar Molding technique (NAM technique). This is a unique technique that is not taught at the majority of pediatric dental residencies. Dr. Birch was fortunate to work with many babies during his time in residency, and really enjoyed the difference that this appliance can make in the lives of the children and parents. He has continued this work with cleft lip & palate babies at Spartanburg Pediatric Dentistry. We are the only pediatric dental specialist in the upstate that implements the NAM technique.

This NAM appliance is beneficial in many ways:

Aligns the maxillary segments of the palate

Lifts the nostrils for better aesthetics

Acts as an obturator, which allows babies to feed easier

Due to babies growth and development, Dr. Birch recommends starting this treatment at the early age of 1-2 weeks old. This is because babies can adjust to the appliance faster at such a young age, and allow them to gain weight. The treatment consists of weekly adjustments to the appliance, and usually is finished by 4-6 months of age when the babies have their first surgical procedure.

What is cleft lip and cleft palate?

Cleft lip and cleft palate are birth abnormalities of the mouth and lip. In the United States, nearly 6,800 babies are born with oral-facial clefts annually. Cleft lip and cleft palate occur early in pregnancy when the sides of the lip and the roof of the mouth do not fuse together as they should. A child can have cleft lip, cleft palate, or both. Cleft lip and cleft palate together are more common in boys. It is also important to know that most babies born with a cleft are otherwise healthy with no other birth abnormalities.

Cleft Palate Cleft palate occurs when the roof of the mouth does not completely close, leaving an opening that can extend into the nasal cavity. The cleft may involve either side of the palate. It can extend from the front of the mouth (hard palate) to the throat (soft palate). Often the cleft will also include the lip. Cleft palate is not as noticeable as cleft lip because it is inside the mouth. It may be the only abnormality in the child, or it may be associated with cleft lip or other syndromes. In many cases, other family members have also had a cleft palate at birth.

Cleft Lip Cleft lip is an abnormality in which the lip does not completely form during fetal development. The degree of the cleft lip can vary greatly, from mild (notching of the lip) to severe (large opening from the lip up through the nose). As a parent, it may be stressful to adjust to the obvious abnormality of the face, as it can be very noticeable.There are different names given to the cleft lip according to its location and how much of the lip is involved. A cleft on one side of the lip that does not extend into the nose is called unilateral incomplete. A cleft on one side of the lip that extends into the nose is called unilateral complete. A cleft that involves both sides of the lip and extends into and involves the nose is called bilateral complete.

NAM Appliance

The NAM or Naso-Alvelor Molding Appliance is a technique in which the alveolus (gum ridges) and/or nose are molded with an appliance similar to an orthodontic retainer.

What are the benefits of the NAM technique?

Typically, children with cleft lip and palate require between five to seven surgeries—sometimes extending into adolescent years. The NAM device reduces the number of surgeries required during a patient’s lifetime, which in turn reduces facial scarring, trauma, inconvenience and cost involved in additional surgeries.

The NAM device dramatically improves postsurgical results for cleft lip and palate patients. In addition, it also may have a dramatic effect on speech and overall health.

Because the NAM device covers the roof of the infant’s mouth, the NAM appliance also helps with feeding.

What is the role of the parents?

Parent participation is essential to the success of the NAM appliance. In addition to scheduled visits to Spartanburg Pediatric Dentistry, parents will be responsible for attaching the tape to their child, which allows the NAM device to stay in place.